Boné B, Aspelin P, Bronge L, Isberg B, Perbeck L, Veress B
Department of Diagnostic Radiology, Karolinska Institute, Huddinge Hospital, Sweden.
Acta Radiol. 1996 Mar;37(2):208-13. doi: 10.1177/02841851960371P143.
The aim of our prospective study was to determine the diagnostic accuracy of MR mammography (MRM) in detecting malignant disease.
In 231 consecutive patients scheduled for surgery because of mammographic or palpable lesions suspected of malignancy, the breasts were examined with T1-weighted transversal images using a 3-D fast low angle shot (FLASH) sequence. One pre- and 2 post-contrast images were obtained. Histological examination of the surgical specimens showed carcinoma in 155 breasts, of which 138 were invasive and 17 in situ.
MRM detected 144 of the 155 malignancies and was false-negative in 11 cases. Eight of these MRM-missed tumours were invasive and 3 were in situ cancers. Benign lesions were found at microscopy in 95 breasts, of which MRM correctly diagnosed 69. The cellular composition of the 26 false-positive lesions (myxomatous stromal change, high vascularity, and epithelial or apocrine hyperplasia) might explain the false positivity. The sensitivity and specificity of MRM were 93% and 73% respectively.
MRM should be interpreted with caution, and supplemented with e.g. mammography and ultrasonography.
我们前瞻性研究的目的是确定乳腺磁共振成像（MRM）检测恶性疾病的诊断准确性。
对231例因乳腺X线摄影或可触及的可疑恶性病变而计划进行手术的连续患者，使用三维快速低角度激发（FLASH）序列进行T1加权横向图像检查乳房。获取1张对比前图像和2张对比后图像。手术标本的组织学检查显示155个乳房中有癌，其中138个为浸润性癌，17个为原位癌。
MRM检测出155例恶性肿瘤中的144例，11例为假阴性。这些MRM漏诊的肿瘤中有8例为浸润性癌，3例为原位癌。显微镜检查发现95个乳房中有良性病变，其中MRM正确诊断出69个。26例假阳性病变（黏液样间质改变、高血管化以及上皮或大汗腺增生）的细胞组成可能解释了假阳性。MRM的敏感性和特异性分别为93%和73%。
对MRM的解读应谨慎，并辅以例如乳腺X线摄影和超声检查。
